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Questions and Answers About Preparation and Planning for Smallpox Vaccination

Are states expected to develop a Health Care Response Team in every acute care hospital in the state?
It is up to each state to decide the number of HCRTs. The ACIP recommends that hospitals should have an option to have an HCRT.

How do I find out who the BT grantee is for my state/area?
All the states, the District of Columbia, territories, and protectorates have been funded for bioterrorism activities. In addition, Chicago, Los Angeles County, and New York City have been funded. You can find contact information for state health agencies at http://www.cdc.gov/other.htm#states.

How do federal programs fit into preparedness activities?
A single case of smallpox in the U.S. would almost certainly signal a biological weapons attack. This would require an immediate, coordinated response by medical and public health systems. The Department of Health and Human Services (DHHS), and in particular its Centers for Disease Control and Prevention (CDC), have taken a number of steps to ensure preparedness, including pre-event vaccination of selected populations. Vaccination of staff of federal agencies in pre-event vaccination programs will vary by agency. The Veterans Administration is planning to vaccinate its own staff. For other federal agencies, their staff would be eligible for vaccination if they were included in state response teams and would be vaccinated through state programs. For some agencies, it has not yet been decided how their staff would be vaccinated. The CDC is prepared to ship smallpox vaccine to grantees and will provide smallpox vaccine handling instructions, cold chain management guidelines, and all appropriate documentation. HHS and CDC also have worked with private industry to expand our supply of vaccine and vaccinia immune globulin and ensure their rapid distribution if needed; worked with the state and federal officials to develop plans to respond to a smallpox release; and worked with federal and state partners to develop and make available clinical and laboratory tools to improve our ability to diagnose a smallpox case if it were to occur.

Who is responsible for vaccinating National Guard members?
National Guard members who are on response teams would be vaccinated by the state.

How should a state handle confidentiality issues related to asking potential vaccinees about contraindications, especially related to employment issues?
Potential vaccinees should be provided educational information in advance so they can decide whether they want to get vaccinated based on contraindications. They should not be required to share their reasons with anyone.

In developing our plans for Mass Vaccination Clinics, it does not seem practical nor cost effective to don gloves or wash hands between each patient who presents for vaccination in a post-event situation. In our state, that would mean 6 million pairs of gloves. What is the recommendation that we are to put in our plan?
In a pre-event situation, gloves are recommended whenever there is a possibility of exposure to reconstituted smallpox vaccine. Persons administering the vaccine should wear gloves. After a person is vaccinated and the needle placed in a sharps container, gloves should be removed and discarded; hands should be disinfected with soap and water or a waterless hand product, and a new pair of gloves donned before the next person is vaccinated.
During a post-event occurrence, at minimum the vaccinator should wear gloves and should change gloves/wash hands as frequently as the circumstance permits.